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ObjectiveTo compare the characteristics of adult and juvenile callers at high risk of suicide from psychological assistance hotline， to screen factors influencing the crisis intervention effect， so as to develop specific intervention programs for different age groups on psychological assistance hotline. MethodsFrom January 2021 to June 2021， a total of 2 229 callers at high risk for suicide were recruited from Beijing psychological assistance hotline. The selected individuals were divided into adult group （n=1 344） and juvenile group （n=885）. Callers were interviewed by the hotline operators. Their general information， suicidal ideation， socio-psychological characteristics and chief complaints were recorded and compared between two groups. Before and after hotline crisis interventions， psychological distress， suicidal ideation intensity and hope level of the callers were assessed， and the improvements in the three assessed dimensions were compared between two groups. Then Logistic regression was adopted to compare the crisis intervention effects on three dimensions and their associated factors. ResultsCompared with adult group， juvenile group reported higher rates of family relationship problems， learning problems， history of suicide attempts and fear of assault， with statistically significant differences （χ2=55.604， 24.706， 41.944， 106.527， P<0.01）. After hotline crisis intervention， the proportion of callers with increased level of hope was larger in juvenile group than that in adult group （42.74% vs. 30.97%， χ2=26.042， P<0.01）. Multivariate Logistic regression analysis showed that the chances of improvement in psychological distress for major depressive disorder （OR=0.650， 95% CI： 0.510~0.827）， the chances of improvement in the level of hope for those with substance dependents （OR=0.550， 95% CI： 0.327~0.926）， and the chances of improvement in the intensity of suicidal ideation for those with stressful life events （OR=0.565， 95% CI： 0.328~0.973） were all higher in juvenile group than those in adult group after crisis intervention. ConclusionAmong the callers at high risk for suicide from psychological assistance hotline， adult callers are more concerned about extra-familial relationships， work and economic problems， while juvenile callers are more concerned about family relationship and learning problems. Furthermore， the effect of crisis intervention in juvenile callers is less affected by major depressive disorder， substance use problems and stressful life events.
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Objective@#To analyze the influence of cognition on suicidal ideation in patients with major depressive disorder.@*Methods@#A total of 108 inpatients with major depressive disorder from January 2017 to September 2018 in Beijing Huilongguan Hospital were enrolled.They were divided into suicidal ideation group (n=42) and non-suicidal ideation group (n=66) by the self-rating idea of suicide scale (SIOSS). Cognition was assessed by Repeatable Battery for the Assessment of Neuropsychological Status(RBANS). The general situation was assessed by self-made general situation questionnaire.The related factors were analyzed by Logistic regression.@*Results@#(1) The rate of suicidal ideation was 44.4% in patients with major depressive disorder.(2) The total score of RBANS and five-factor scores of RBANS in suicidal ideation group were lower than those in non-suicidal ideation group(total RBANS score(63.0±7.9) vs (73.8±7.7); immediate memory: (62.7±8.8) vs (70.8±7.6); visual span: (67.2±10.0) vs (72.7±9.8); speech function: (83.3±13.8) vs (91.5±4.5); attention: (85.3±11.9) vs (99.9±8.5); delayed memory: (53.5±7.7) vs (62.3±9.7), F=6.335-46.660, P<0.05). (3)Logistic regression showed, years of education were risk factors for suicidal ideation(β=0.289, P=0.013, OR=1.335, 95%CI=1.063-1.676), RBANS attention factor(β=-0.161, P=0.000, OR=0.851, 95%CI=0.778-0.931)and RBANS delayed memory factor score(β=-0.151, P=0.006, OR=0.860, 95%CI=0.772-0.957)were protective factors for suicidal ideation.@*Conclusion@#Cognitive function has an impact on suicide ideation of depressive patients, mainly attention and delayed memory are protective factors for suicide ideation.
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Objective To analyze the influence of cognition on suicidal ideation in patients with major depressive disorder. Methods A total of 108 inpatients with major depressive disorder from January 2017 to September 2018 in Beijing Huilongguan Hospital were enrolled. They were divided into suicidal idea- tion group ( n=42) and non-suicidal ideation group ( n= 66) by the self-rating idea of suicide scale (SIOSS). Cognition was assessed by Repeatable Battery for the Assessment of Neuropsychological Status (RBANS). The general situation was assessed by self-made general situation questionnaire. The related fac-tors were analyzed by Logistic regression. Results (1) The rate of suicidal ideation was 44. 4% in patients with major depressive disorder. (2) The total score of RBANS and five-factor scores of RBANS in suicidal i-deation group were lower than those in non-suicidal ideation group(total RBANS score(63. 0±7. 9) vs (73. 8 ±7. 7);immediate memory:(62. 7± 8. 8) vs ( 70. 8± 7. 6);visual span:( 67. 2± 10. 0) vs ( 72. 7± 9. 8);speech function:(83. 3±13. 8) vs (91. 5±4. 5);attention:(85. 3±11. 9) vs (99. 9±8. 5);delayed memory:(53. 5±7. 7) vs (62. 3±9. 7),F=6. 335-46. 660,P<0. 05). (3) Logistic regression showed,years of educa-tion were risk factors for suicidal ideation ( β=0. 289, P=0. 013, OR=1. 335,95% CI=1. 063-1. 676), RBANS attention factor(β=-0. 161,P=0. 000,OR=0. 851,95%CI=0. 778-0. 931) and RBANS delayed memory factor score(β=-0. 151,P=0. 006,OR=0. 860,95%CI=0. 772-0. 957) were protective factors for suicidal ideation. Conclusion Cognitive function has an impact on suicide ideation of depressive patients, mainly attention and delayed memory are protective factors for suicide ideation.
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Objective To explore the attribution of suicidal behavior which was judged by different respondents of suicide and suicide attempts.Methods Suicide attempts (120 cases) and suicide deaths (151 cases) were recruited.For each cases,a co-habitat family member and an associate (majority were neighbors) were interviewed independently.The attempter himself/herself was also interviewed.Every respondent reported the cause of the index suicide behavior,life events occurred one year prior to suicidal behavior,and depressive symptoms in one month prior to suicidal behavior.Results For suicide group,31.2％ of family member respondent attributed the index suicidal behavior to physical illness,15.6％ of them attributed it to family conflicts,and 7.8％ of them attributed it to depression.However,among associate respondents,24.8％,28.4％ and 13.5％ of them attributed the index suicidal behavior to physical illness,family conflicts,and depression.Family members were less likely attributed suicidal behavior to family conflict (x2=11.17,P ＜0.01),and associates were less likely attributed it to physical illness (Fisher's exact test,P＜0.01).In suicide attempt group,61.2％ of attempters themselves,60.5％ of family members and 69.2％ of associates attributed suicidal behavior to family conflict;10.3％ of attempters themselves,11.4％ of family members and 3.4％ of associates attributed it to physical illness.The associates were less likely attributed it to physical illness (Cochran Q=12.80,P＜0.01).Only 4.3％ of attempters,2.6％ of family members and 2.6％ of associates attributed index suicide behavior to depression.In the attempt group,29 attempters themselves,14 family members and 9 associates reported that the attempter had five or above depressive symptoms,but only 1 attempter himself,1 family member and none of associates attributed the attempt to depression.In suicide death group,45 family members and 49 associates reported the decedents had five or above depressive symptoms,but only 6 family member and l0 associates attributed index suicidal behaviors to depression.The respondents who attributed index suicidal behavior to family conflict reported a higher score of acute stress due to life events of family conflicts.Conclusion All respondents underestimate the effect of depression on suicidal behaviors.It is important to promote public health education on depression.Family conflict is one of the major precipitating factors of suicide behavior in China.
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Objective To explore the efficacy of group cognitive behavioral therapy for improving depressive symptoms and social functional in patients with major depressive disorder.Methods A total of 160 patients with major depressive disorder were randomly divided into intervention group (n=80) and control group (n=80).Intervention group was treated with conventional antidepressants combined with group cognitive behavioral therapy.Control group was treated with one conventional antidepressants.All participants were assessed with Hamilton Depression Scale (HAMD)and Scale of Social function of Psychosis Inpatients (SSFPI) before and 8 weeks after the treatment.Results After 8 weeks treatment,the scores of HAMD (14.76±9.48) was significantly reduced and the scores of SSFPI(30.09±4.34) were significantly increased in intervention group compared with the baseline ((37.91± 10.58),(12.40±2.56),all P＜0.01).The scores of HAMD were significantly lower and the scores of SSFPI were significantly higher in intervention group than that in control group((20.71±7.85),(22.63±3.63),all P＜0.01).Conclusion Group cognitive behavioral therapy is effective for major depressive disorder patients by reducing depressive symptom and improving social function.
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Objective:To develop the Counseling Skills Rating Scale for Psychological Aids Hotline (CSRSPAH),an instrument to objectively assess the quality of process of counseling or intervention provided by hotline operators,and to test its validities and reliabilities.Methods:A draft of the scale,which consisted of 50 items under 5 dimensions,was designed in line with previous researches and the practice.In pilot study,supervisors at Beijing psychological aids hotline,assessed tape recorded sessions and gave feedbacks on the draft of the scale.The scale had been revised based on the pilot study.Twenty-eight items were deleted,and several items were rephrased.Finally,a scale which consisted of 22 items within 3 dimensions,i.e.counseling process,attitude,and communication skill,was developed.The scoring standards of the scale were also developed.To evaluate the IntraClass Coefficients (ICC) of the CSRSPAH,each of the tape records of 37 callings from 2005 to 2007 were assessed by 7 supervisors independently,using the scale.And the tape records of other 318 callings from 2013 to 2014 were also assessed by supervisors,using the CSRSPAH.The results of the 318 assessed callings were used to test the construct validities with the Confirmative Factor Analysis.The Cronbach a coefficients of the total score and three dimensions,the discriminant indices of every items,and correlations of each items and each dimensions were calculated,based on the 318 assessed callings.Results:One of the items (referral) was deleted due to excessive amount of missing data.Results of cortfirmative factor analysis of the remained 21-item scale revealed that the 3-factor construct structure of the scale was robust.The fitting indices of the confirm factor analysis were,x2/df=675.21/186,CFI =0.92,NNFI =0.91,RMSEA =0.10,SRMR =0.08.The Cronbach α coefficients of the total score,scores of counseling process,attitude,and communication skill,were 0.89,0.68,0.81 and 0.77,respectively.The ICCs of the inter-rater reliabilities of the total score and 3 dimensions of the scale were 0.67,0.59,0.59,and 0.67,respectively.The discriminant indices of all the 21 items ranged from 0.09 to 0.32.The correlation coefficients of scores of each items and scores of 3 dimensions and total scores were greater than 0.30,and reached statistical significance.Conclusion:The validities and reliabilities of the Counseling Skills Rating Scale for Psychological Aids Hotline are acceptable.The scale could be used in assessing the quality of hotline counseling or intervention,and related studies in the future.
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Objective To compare the identifiability for depressive symptoms using different instruments while interviewing with different respondents in suicide prevention research in China. Methods One hundred and fifty-one suicide death cases (suicide group) and one hundred and twenty suicide attempt cases (attempt group) were recruited. For each identified cases, one family member proxy respondent, and another associate proxy respondent (friend or neighbor) and suicide attempter (only for attempt group) were interviewed separately by qualified psychiatrists. The Di-agnostic Screening Instrument for Depression (DSID) and the Structured Clinical Interview for DSM-Ⅳ Axis Ⅰ Disorders (SCID-Ⅰ) were administered to each respondent to identify the depressive symptoms based on diagnostic criteria for major depressive episode in DSM-Ⅳ. Data collected from family members and associate respondents were merged as proxy data. The concordances of the DSID and SCID-Ⅰfor identifying depressive symptoms, meeting for criteria of Major Depressive Episode (MDE) and Mild and Major Depressive Episode (MMDE), were calculated based on different respondents' data. The prevalence of depressive symptoms, MDE and MMDE, were compared among merged proxy data, family member respondent's data, and associate respondent's data in suicide group and attempt group, and between self-respondent's data and merged proxy data in suicide attempt group. Results In suicide group, based on merged proxy data, the prevalence of MDE was 41.1%(62 cases) for DSID and 41.7%(63 cases) for SCID-Ⅰ, and the Kappa coeffi-cient was 0.77. Based on suicide attempters' self-raported data, the prevalence of MDE was 23.7% (27 cases) and 22.0% (24 cases) for DSID and SCID-Ⅰ respectively, with a Kappa of 0.74. Based on merged proxy report in attempt group, 16 (13.3%) and 15 (12.5%) cases were met for criteria of MDE (Kappa=0.89), using the 2 instruments. In both of the suicide and attempt groups, the merged proxy data got higher prevalence of depressive symptoms, MDE and MMDE than that only based on family respondent's data or associate's respondent's data using both of the 2 instruments (all P<0.05). Compared with merged proxy data, attempters' self-reported data got higher prevalence of MMD and MMDE using both of the 2 instruments (all P<0.05). Conclusions Based on same respondent's data, SCID-Ⅰ performs as well as DSID in identifying depressive symptoms. Collecting data from 2 respondents would get higher prevalence of MDE or MMDE than only from one family member or one associate. In attempt group, the prevalence of MDE or MMDE based on merged proxy data were lower than that based on attempters' self-reported data.
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Objective To conduct concordance test on Life Event Scale reported by different informants and the suicide-attempters themselves in Chinese suicide research. Methods In this retrospective study, 104 attempted suicide cases and 147 suicide cases were included. Each case had two informants. One was family member, and the other was associate (friends, neighbors, etc.). Suicide attempters (only for attempted suicide cases) were also interviewed by qualified psychiatrists. Life Event Scale was administered to each respondent to obtain life events experienced by the case before the suicidal behavior. Kappa and Intraclass Correlation Coefficient (ICC) were used to compare the suicide attempters' self-reports with two informants' reports, and to present the concordance of two informants' reports for suicides. Results For attempted suicide group, agreements were nearly moderate or better for life events on marital relation, physical illness, family relation, love, birth or death of family members (Kappa≥0.39); Proxy-based chronic stress and acute stress scores were significantly lower than subject-reports (ICC:0.11~0.24, P<0.01).For suicide group, the agreements between the two informants' reports were moderate or better on death of spouse, work/study or physical illness (Kappa≥0.49); The agreement for chronic stress score was fair (ICC=0.47). Conclusions The results have demonstrated that proxy-based data on life events are valid if structured and objective scales are used.
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Objective To Compare characteristics between the psychological aids hotline callers who had single attempted suicide and those callers who had repeated attempted suicide. Methods The analysis was conducted on the da?tabase of Beijing psychological aids hotline from Dec., 2002 to Dec., 2008. All the effective callers were consulted by pro?fessional hotline operators. During the calling, the callers were interviewed on their attempted suicides, depression and 11 correlates associated with caller's suicidal behaviors. Results Among 4519 callers who had attempted suicide, 2441 (54%) of them had attempted suicide once, and the other 2078 (46.0%) callers had repeated suicide attempts. After ad?justed for gender, age, and the other 4 demographic variables, history of being abused (OR=1.35, 95%CI: 1.08~1.67), afraid of being attack (OR=1.35, 95%CI: 1.01~1.59), relatives or associates with prior suicidal behavior history (OR=1.17, 95%CI: 1.001~1.36), hopelessness (OR=1.20, 95%CI: 1.02~1.40), and psychological treatment history (OR=0.73, 95%CI:0.62~0.86) were associated with repeated suicide among hotline callers. Conclusions To improve the effective?ness of hotline based suicide prevention, assessment of risk of repeated attempted suicide among the callers with a histo?ry of prior attempted suicide should focus on the history of being abused, afraid of being attack, hopelessness, relatives or associates with prior suicide history, and psychological treatment history.
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Objective To examine the different effects of impulsive and aggressive personality on college students' suicide attempt. Methods Four thousand nine hundred eighteen sophomores and juniors were selected according to the principle of cluster sampling from Beijing agricultural university and Beijing university of information science and tech?nology. Four thousand seven hundred ninety-seven of them completed the survey. Their impulsive and aggressive person?ality were evaluated by the Barratt Impulsiveness Scale-Chinese Versions (BIS-CV) and the Buss-Perry Aggression Questionnaire-Chinese Versions (AQ-CV). A self-made questionnaire were used to investigate suicidal idea and self-in?jury/suicidal behavior of college students. Results Among the sophomores and juniors, 18 participants had self-injury/suicidal behavior (3.75‰) and 1843 had suicidal idea (38.42%). Compared with the students who didn’t have self-inju?ry/suicidal behavior, those who once had self-injury/suicidal behavior had significantly higher BIS-CV score (P<0.01) and higher scores of non-planning and motor factors (P<0.05). They also had significantly higher score in AQ-CV and the factors of physical aggression, verbal aggression, anger, hostility and pointing to the self attacks (P<0.01). Conclu? sions The college students with self-injury/suicidal behavior have higher tendency in impulsive and aggressive personali?ty. Therefore, it is necessary to prevent suicide behavior, form high impulsive and aggressive intention and behavior.
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Objectives:To explore the prevalence and correlates of attempted suicide among Beijing psycho-logical aids hotline callers,in order to provide knowledge of hotline-based suicide prevention.Methods:From De-cember 2002 to December 2008,all the effective callers who consulted themselves'psychological problem,by Bei-jing psychological aids hotline were interviewed by professional hotline operators during the consulting calling.Data of whether callers attempted suicidal behavior in 2 weeks prior to the calling,gender and other 5 demographic char-acteristics of callers were collected via hotline interview.A questionnaire including depression screening scale,com-mon psychiatric symptoms such as delusion,hallucination,etc.,a history of substance abuse or dependence,a histo-ry of suicidal behavior,having had acute or chronic life events,and severity of hopeless was used during hotline in-terview.Logistic regression model was used.Results:In 22 415 interviewed callers,362 (1.6%)callers (233 fe-males)reported that they attempted suicidal behavior in 2 weeks prior to the calling.After adjusted for demographic characteristics,prior suicidal behavior 2 weeks before calling (OR=4.43,95%CI:3.37-5.83),hopelessness (OR=2.01,95%CI:1.52-2.67),substance abuse (OR=1.97,95%CI:1.48 -2.62),acute negative life events (OR=1.94,95%CI:1.49-2.52),and severe depressive symptoms (OR=1.45,95%CI:1.08-1.95)were associatedwith attempted suicide among hotline callers.Conclusion:The rates of attempted suicide among hotline callers are probably high.Suicide prevention in hotline would shed light on improving coping skills for life events and sub-stance abuse problems for hotline callers.
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Background Based on prior research in the field, a preliminary questionnaire was created to compare the coping strategies of schizophrenic patients to those of non-ill community residents. Results of the comparison were subsequently used to develop a questionnaire suitable for use in schizophrenic patients.Methods Ninety-one of the 92 items in the preliminary questionnaire were identified from previous questionnaires, and one additional item was created based on information provided in individual interviews with schizophrenic patients. This questionnaire was administered to 315 community controls and 208 schizophrenic inpatients. Exploratory Factor Analyses to identify the factor structure of coping strategies were independently conducted for controls and patients. Based on these results, a revised 65-item instrument was developed and administered to a new group of 287 controls and 219 schizophrenic inpatients. Confirmatory Factor Analyses (CFA) using Linear Structural Relations (LISREL) were independently conducted for the two groups to confirm their respective factor structures.Results Six coping categories identified in normal controls were problem solving, avoidance, cognitive adjustment, emotional adjustment, seeking special support, and denial. Among schizophrenic patients, however,coping strategies of "seeking special support" and "denial" were not independent of the other four coping categories. Their items were distributed among the others. Results of CFA confirmed this four-category model of coping strategies for schizophrenic patients.Conclusions Coping categories employed by schizophrenic patients were different from those employed by normal community controls. Schizophrenic patients lacked the necessary flexibility of selecting appropriate coping strategies.
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The personality abnormality is a remarkable characteristic in schizophrenia. Some evidence to date indicated that there existed measurable scores of personality traits in schizophrenic patients, though the psychotic symptoms were concomitant. The psychotic symptoms were deemed to influence the assessment of personality traits in schizophrenia for the symptoms and personality abnormality were entangled tightly. Yet, it cannot exclude the personality pathology in the psychopathology of schizophrenia. Moreover, the personality abnormality was related to cognitive deficit, prognosis, and insight in schizophrenics. It was difficult to disentangle the relationship between personality psychopathology and schizophrenia. Spectrum, pathoplasty, and etiology model each could explain the relationship partially. An integrated viewpoint incorporating all three models was discussed. However, it needs further researches to investigate some important issues such as the physiological basis and psychological mechanism of the relationship, the influence of culture on personality assessment.